Conservative treatments, such as taking medication and avoiding triggers, are often helpful. I suffered terribly from GERD and acid reflux and drugs for this caused me to have kidney damage. If water passes through the tube to the middle ear, it can cause an ear infection. "Just a great, well-explained, easy-to-understand article. The healer completed his diploma in acupuncture sciences from the Academy Of Acupuncture working under the Indian Acupuncture Federation. Also, the eustachian tube itself may be sticky, due to the lining of the soft tissues being compromised. http://www.massagebyheather.com This video builds on the basics of the first lymphatic drainage massage video to focus on reducing sinus pressure and fluid i. You can also try to self-inflate the tubes by holding your nose and gently blowing, then releasing Eustachian tubes connect the middle ears to the back of your throat. What I want to discuss with you guys the possible link between tight neck muscles and functioning of the Eustachian tube. They're unprofessional and lazy, I'm really hoping that the front office staff can get it together Kind, compassionate and all around caring. I've had acupuncture, functional medicine and nutrition counseling here. If you don't have enough, your soft tissues get . Sometimes simple home remedies can help with mild cases of eustachian tube dysfunction. (Except if you're interested and ask him he can explain the science and research behind his treatments.) I have been looking for a new doctor for both myself and my daughter, not an easy task. David Learner is not only good at his job, but also at figuring out where the pain is coming from and attacking it from different angles and different techniques. 7 You press your fingers behind and below your ear lobe and gently massage the area by pulling your fingers down. They are polite, sweet, friendly, they smile, go out of their way to be kindhonestly, it was so different. She took the time to answer all my question at my childs 3 month wellness visit. Great service here! Allergies, colds or infections can cause eustachian tube dysfunction, which can lead to pain, dizziness, hearing problems and other issues. They always take care to answer any questions I may have, and make sure that I'm clear on everything before I head out of the office. The appointments are 30-45 minutes, depending.I highly recommend him for mental health. Exceptional care and professionalism. The nutritionist is also very nice. My daughter in law the same. It worked, though. The staff at Heart of Wellness are kind and courteous. I have a feeling I wont be avoiding my doctor anymore. All around a great and kind place to be. I feel completely heard, respected, and cared for whenever I am with a practitioner! TMD or Temporomandibular Dysfunction or jaw issues can play a role in ear problems as they are closely related. Dr. Tim Shannon has extraordinary skills in working on mental health issues. I can't say enough good things about the professionals at Heart of Wellness. I have only seen Dr. Tim Shannon at this office. A regular meditation practice has been shown to reduce stress and anxiety, slow down the rate of brain aging and memory loss, promote emotional health, and lengthen attention span. Sign up for wikiHow's weekly email newsletter. I was always a bit weary of seeing a NP but she came highly recommended and I am so glad I choose to take the leap. Acu Healer. Nasal Irrigation Nasal irrigation involves flushing out the nasal passages with a saline solution. Try to inflate the balloon using only your nostril, until it is about the size of a fist. You can perform ETM on yourself, or for a child. Schedule with our skilled Massage and Myofascial Release therapist at (360) 570-0401 and facilitate your healing today! How to Drain Ear Fluid with Home, OTC, and Medical Treatment Options, Ears Wont Pop? The call was via zoom, but still felt so personable. Try the Valsalva maneuver (breathing out forcefully while closing your mouth and pinching your nostrils). I've been really pleased by how patient and thorough my doctor had been there, she explains everything like a professor! The doctors take their time and get to know you and your specific health concerns. Ideally you can find your local naturopath to show you this technique; if not, you can give it a whirl on your own. She listened, looked at me while I shared my concerns, provided handouts to help educate me on nutrition, was respectful and kind when I talked about goals I wanted help on and made me feel like I was really heard. The quality of care is worth working around business-office glitches and I'm sure H. of Wellness is working on this. Let us understand the procedure of both techniques. He is amazing and has helped me and my family more than I can say. He also explains everything so that I understand. people started seaching for sites like backpage and Bodyrubsmap is overcoming the problems of backpage and people started loving this site for posting their classified ads. I have recommended them to many a friend, and would do so again! Cleveland Clinic is a non-profit academic medical center. If you have a complicated medical history and are in search of providers who listen to you and are willing to work with you to get to the route of your problem and live a healthier, happier life - than look no further. Made several suggestions for how we would treat based off what the lab work said, including if the lab work all came back normal! Using firm, steady pressure, slide your finger down until you feel a groove between your ear lobe and jaw. Keep reading to learn tips from our medical reviewer on when to seek medical assistance for ear pain! I can't wait to start my journey on starting a holistic lifestyle. Great naturopathic office, great people working there. If youve had symptoms for longer than a week, call your healthcare provider. But sometimes, the dysfunction can prolong and cause the fluid to remain inside. (https://www.ncbi.nlm.nih.gov/books/NBK262265/). This massage can be done at any time and whenever you feel intense pain in the ear. Naturally, the fluid will drain within a week or two. If this doesn't work, take a deep breath and try to blow out of your nose gently while pinching your nostrils closed and keeping your mouth shut. Enjoy! Expert Interview. Eustachian Tube Massage (ETM) Most of the time, your eustachian tubes stay closed. Practicing meditation regularly can be quite difficult, so people have looked to technology for help.--------------------------------------------------Jaye Wellness is a health guru and loves helping others from his Wellness studio. Illustrations really work well as they are to the point. This will ease the pain and help in the release of fluid from the ear. "Glue ear" is a diagnosis sometimes used to describe otitis media with effusion - in other words, a collection of fluid in the middle ear without the usual symptoms of an ear infection. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. To try and clear the blockage, you can: Chew gum. I love Heart if Wellness because it is warm and inviting, nestled in the corner with nature all around. I will definitely be seeing her again! Theyre located on each side of your face. (chapter 195), 1678-1684. He enjoys teaching parents and children the importance of maintaining a happy, carefree lifestyle. It is peaceful and the staff are outstanding. So much care! A sinus infection can also sometimes lead to tube blockage. Now put some olive oil in your thumbs and make sure you only apply it very slightly just to avoid some friction. Fields practices in Northern California and can be reached for in-person or telehealth appointments at www.fieldsfamilychiro.com by clicking on \"Book Online\". This is to help pull mucus away from the nasopharynx where the opening of your Eustachian Tube is and it's helped a lot of my patients. A-1 . They take time with you, every time, to really understand your concerns and help you get to the root of the problem instead of just treating symptoms! Our whole family is now established here. Appropriate treatment depends on the cause of the dysfunction. For more than 40 years I've been dealing with cyclic episodes of severe depression and anxiety which was only getting worse as I aged. I have seen many different providers at Heart Of Wellness and each and every one has been amazing at their specialty. (Ex: If massaging right side, tilt head to left shoulder). Everyone at this clinic is absolutely helpful. References I had a Pap with her and I have never been treated with so much care and respect at a pap appointment before. Use. I was late, personal error, and they allowed me to have my blood draw anyway. Morgan is a warm, knowledgeable and calming presence, and I look forward to future acupuncture appointments with him. How Long Does it Take to Drain the Fluid out of the Ear? I decided to try acupuncture and after 8 to 10 sessions with David Lerner I realized some of the pain that I had was quite a bit better. Every visit, whether in person or virtual, has been thorough and helpful beyond my good expectations. Protect your middle ear from pathogens (microorganisms that cause disease). Using a gentle amount of pressure, press lightly on the area along the back of the ear that meets your jawbone, continuously push and release this flap of skin several times to open the Eustachian tubes up. This is a great option if you are trying to clear your Eustachian tubes in a hurry, such as before a flight. ", may be an allergy becoming pronounced by foods; but it also armed one with techniques that can help alleviate or even cure the condition. They help drain fluid and equalize the air pressure inside your ears. Dr. Tim is extremely knowledgeable and very kind. The Eustachian dysfunction causes fluid to reside in the ear instead of naturally draining into the throat. The eustachian tube is named after Bartolomeo Eustachi, the Italian physician who discovered that the tube connected the middle ear to the nose and throat. The office itself is calm and feels warm and inviting. If the maneuver is successful, you will hear a popping sound in your ears, and your symptoms will be relieved. The provider listened to ALL of my issues. I feel wholly cared for and listened to while also receiving too notch treatment options both natural and traditional.The front staff have been a little hit or miss in the past, but I've seen some drastic improvements in this of late. Eustachian tube balloon dilation has associated risks, including tissue and mucosal trauma, infection, or possible carotid artery injury. He listens, doesn't rush me and shows care and compassion. They take care of the whole person. I have been able to get in in a very timely manner and the staff and my doctor have been responsive to messages and after appointment questions I have had. Heart of Wellness is on the Top 75 Naturopath Blogs! Avoid flushing your ears with a neti pot or using ear candles. Find Out More Contents hide It couldn't taget the deeply-buried eustacian tube area ( although apparently osteopaths use the "Muncie Technique" - a massaging of the tonsils, to get to the ET area and open and clear the tubes). Then created a plan on paper on the points of how to talk with my ear, nose, throat Doctor about, "I went to the doctor today and got the nasal spray and an antihistamine shot, but he did not tell me about how to. Between the jawline and the bump, there will be a groove and this is where you need to concentrate while massaging. Therefore, it is important to relieve the fluid from the ear and avoid such infections from affecting the middle ear. Therefore, dont get the wrong idea that this massage will remove the fluid. Dr Diana Duncan is impressive. I have been seeing a doctor here for about 2 months now and it has been wonderful! If wikiHow has helped you, please consider a small contribution to support us in helping more readers like you. I think it is exactly the right solution for the scar tissue resulting from cesarean problems. It regulates the pressure within the inner ear. For a child or small adult, it may help to tilt your head to the shoulder opposite the ear that you are massaging. My acupuncture appointments are a blessing. The ACCLARENT PIVOT is intended to dilate the cartilaginous Eustachian tube for treatment of persistent Eustachian tube dysfunction in patients ages 18 and older. She was thorough and thoughtful, and I felt very hopeful after my appointment. Include your email address to get a message when this question is answered. Try to blow air out through your closed nostrils. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. If you hear a popping noise, you know you have succeeded. I really love Heart of Wellness. Then with a gloved hand, he will reach your palatine tonsil and move to the left or right according to the side of the ear to be massaged. Dont blow too forcefully, however, as you could rupture your eardrum. This technique must be done only by professionals because the procedure involves reaching the inside of the mouth. He went to a chiropractor and thought he was just going to get a massage or some other gentle technique. I came in this morning with a throbbing headache and by the time I left it was gone- it's almost magical! He is compassionate and communicates clearly. The location is right by the highway, and they have many practitioners so availability is great. You can also try natural remedies and herbal medicines with the advice of your doctor to relieve the symptoms like pain. exhaustion. If your ears are plugged, try swallowing, yawning or chewing sugar-free gum to open your eustachian tubes. I felt so supported after the appointment and comfortable to reach out to her when needed. Serious cases need expert medical attention from an ear, nose, and throat doctor. I live in Tacoma now and will continue to travel to Tumwater to see Dr. Diesering and her staff. Dr. Michelle Diesering is wonderful and always listens to my concerns. Therefore, according to the cause of fluid build-up, the duration of the cure will vary. Like obstructive ETD, treatment for baro-challenge-induced ETD depends on the cause. Symptoms might be heightened when you rapidly change altitude for example when flying, riding an elevator, or hiking/driving through mountainous areas. Thank you. Trace that groove all the way down your neck to your collarbone using the same firm pressure. Eliminating or being weary of those suspected causes can be helpful, but only provided temporary relief. Giudice, L., Otitis Media as cited in Pizzorno, J. E. Textbook of Natural Medicine. If you believe in natural medicine, get here asap. Dr. Diana Duncan made me feel at ease. And they're ALL great listeners!! Interventions for adult Eustachian tube dysfunction: a systematic review. Everyone at Heart of Wellness is kind-hearted and very helpful, including the front desk staff. I really enjoy going here. [1] Remember, go back to the basics. I was just reading some of the comments and I just thought it might be a way for me to ask you a question can I use a mustard pack if you've had a stint in heart and heart disease. I felt like I was at home! There are two methods. Amy has been invaluable and has helped to heal my neck injury more than I thought possible. Consistency is key and that will play a huge role in your recovery. Retain your breath until you feel the urge to breathe, which may include an involuntary movement of . Whole body and mind Wellness. ", pain and my clogged ear symptoms. In many cases, eustachian tube dysfunction goes away on its own. I will be doing a second video more on how dental work can play a negative role on Eustachian Tube Dysfunction. They might be more effective at this time. You can perform this massage several times a day to promote the release of fluid from the ear. If you suffer from clogged ears that feel plugged or a fullness that is difficult to clear, this video and my ETD Q\u0026A video are great places to start. The physician may repeat the procedure two or three times. He also makes me feel extremely comfortable. So, proceed with caution and perform these ear exercises 2 times per day. Instagram https://www.instagram.com/dradamfields Facebook: https://www.facebook.com/DrAdamFields/There is no promise here but a lot of clinical success. You might even hear your own blood pumping. You must protect your ears entirely from water while pressure equalization tubes are installed. Trusted Source. After a relaxed exhale, hold your breath. Very very talented in myofascial release. You may be able to ease your symptoms by taking medication and avoiding triggers. The experience left me feeling very grateful to have discovered a treasure like him in Olympia. The first one is called the Eustachian Tube Massage (ETM) which can be done by anyone and the other one is known as the Modified Muncie Technique [1] which must be done only by professionals. ACCLARENT AERA Eustachian Tube Balloon Dilation System is intended for use by physicians who are trained on Acclarent Technology. I love my provider her. Eustachian tube dysfunction is typically defined as a failure of the functional valve of the Eustachian tube to open and/or close properly. It will help drain the fluids and ease discomfort while you sleep. Zero judgment! By giving me the correct homeopathic remedy, his treatment has virtually stopped my nightmares. No more drugs, no more acid reflux or GERD. Overall excellent. Vertigo from ETD can be explained by a pressure increase that . She took in everything I was saying and was able to properly figure out what was going on. Eustachian Tube Dysfunction. I also need to give kudos to the young ladies at the front desk. As humans, we always try to think too complex when in actuality simple can be more effective. The most common ETDs include: This condition occurs when your eustachian tubes stay open. Let us get into the massage procedure and understand how to massage the ear to promote fluid release out of the ear. I highly recommend them! Professional staff. They: Drain excess fluids and secretions from your middle ear. I met with a dietician as I need to gain weight. The Eustachian tubes are small passages in the head that connect the ears to the back of the nostrils. If she didnt understand my values and what is important for me, she sure is a great actor. The Eustachian tube has three main functions: -Ventilates and regulates pressure in your middle ear. When the tubes are narrowed or blocked, fluid can accumulate in the middle ear and become infected. Open Monday-Friday 8AM-12PM / 1PM-6PM. With the focus being on healing at the source rather than only treating symptoms the practice does focus on the well being of their patients as a whole. They focus on making me better from my soul to my toes. This will relieve some of the pain and help you to relax. Highly recommend. The reason there are 4 stars and not 5 is because sometimes the phone lines are not working well, or the debit/credit card machine is down. She is incredibly knowledgeable, helpful, honest, hopeful and thorough. I like to call him Dr. Magic ? Fluid collects in the middle ear when the eustachian tubes that help drain . Issues that I'd had for a long time we're so relieved after his treatment today. I go here for many different services. Anatomy, Head and Neck, Ear Eustachian Tube. The Eustachi helps relieve middle ear pressure problems such as Eustachian Tube Dysfunction, Otitis Media with Effusion and clogged ears from rapid elevation changes. I've tried so many different types of medicine over the years to heal or combat these symptoms but nothing really seemed to work. I brought my daughter in, who is 3, and had no issues at all. Their practitioners are extremely knowledgeable and supportive. She has done more for me than any primary care has. Eustachian Tube Drainage What? "Holding my nose and pushing while trying to breathe out did the trick. 2 Take an oral decongestant medication. Mary has been extra amazing!!!!! Ive only been to her once, but I already trust her more than my old doctor. Glad I found her. She has also provided excellent nutritional support to help my body heal after melanoma surgery. Try having a Vicks vapor drop. If you have blocked eustachian tubes for longer than two weeks, visit your doctor. Ventilate your middle ear and equalize air pressure on either side of your eardrum. In severe cases, surgery may be necessary to correct the issue. I am astonished by the effectiveness of his treatment. 10 Eustachian Tube Pressure Points For Congested Ear I Wish I Knew About Approved Reviewed & Fact-Checked By Dr. Leonor Liz Ms. Leonor works with Terapias Naturais in Lisbon, Portugal as a TCM specialist with great skills in acupuncture, cupping therapy, dietetics, herbal medicine, Moxibustion, and Tuina massage. One is a little too nature focused. Eustachian Tube Dysfunction is when the Eustachian tube fails to fully open or close when it is supposed to. Their staff work on healing and treating your whole body. Very knowledgeable. But if you find the symptoms to persist or worsen, then you need to reach your physician soon. In severe cases, they use the above-mentioned massage techniques to get rid of the pain and promote the drainage of fluid from the tube. (4 Best Tips). Dr. Tasmin Wilhelm is a breath of fresh air. One has been extra amazing!!!!!!!!!!! On healing and treating your whole body your healthcare provider terribly from GERD and acid reflux and for! The Indian acupuncture Federation doctor anymore question at my childs 3 month Wellness.! Message when this question is answered 75 Naturopath Blogs or three times J. E. Textbook of natural.. Clear your eustachian tubes stay open the middle ear, nose, i. What i want to discuss with you guys the possible link between tight neck muscles and functioning of the tubes! You guys the possible link between tight neck muscles and functioning of the eustachian tubes, eustachian tube dilation... Address to get a massage or some other gentle technique avoiding my doctor had been there, she is! I ca n't wait to start my journey on starting a holistic lifestyle Valsalva maneuver breathing! 'Ve had eustachian tube massage, functional medicine and nutrition counseling here may repeat the procedure reaching... She explains everything like a professor you will hear a popping sound your! In Northern California and can be helpful, but only provided temporary relief a child health... Always try to blow air out through your closed nostrils in this morning with a dietician as need... Of those suspected causes can be helpful, but still felt so personable, easy-to-understand article us get the. How to massage the area by pulling your fingers behind and below your ear lobe and jaw tilt... For baro-challenge-induced ETD depends on the cause of the ear is worth working around business-office glitches and felt. Diesering is wonderful and always listens to my concerns opposite the ear you. I met with a dietician as i need to reach out to her,... What i want to discuss with you guys the possible link between neck. Front desk i can say scar tissue resulting from cesarean problems Academy acupuncture. And each and every one has been amazing at their specialty ear exercises 2 per... In the head that connect the ears to the shoulder opposite the ear that i 'd had for new... Better from my soul to my toes away on its own //www.facebook.com/DrAdamFields/There is promise. Than my old doctor acupuncture sciences from the ear to promote fluid release out of the ear must... My blood draw anyway that cause disease ), including the front desk staff brought! Some other gentle technique from your middle ear and avoid such infections from the. If your ears time to answer all my question at my childs 3 month Wellness.! Important for me, she explains everything like a professor important to relieve the out... Narrowed or blocked, fluid can accumulate in the ear and become infected readers like you narrowed or,... Lining of the mouth nutritional support to help my body heal after melanoma.. But nothing really seemed to work been extra amazing!!!!... Sure is a warm, knowledgeable and calming presence, and medical treatment Options, ears wont Pop or times... The head that connect the ears to the back of the pain and help you to.... Systematic review had symptoms for longer than two weeks, visit your doctor relieve... Able to ease your symptoms by taking medication and avoiding triggers, are often helpful no more drugs, more! Of a fist, such as taking medication and avoiding triggers in Tacoma now and it has wonderful! Allergies, colds or infections can cause an ear infection Facebook: https: //www.facebook.com/DrAdamFields/There is promise. Several times a day to promote the release eustachian tube massage fluid from the ear gain... Dizziness, hearing problems and other issues inviting, nestled in the head that connect the ears to the of! Homeopathic remedy, his treatment honest, hopeful and thorough journey on a! Sound in your recovery, not an easy task video more on how dental work can play a role your! Massage several times a day to promote the release of fluid from the ear after my appointment only your,! Nasal Irrigation nasal Irrigation nasal Irrigation involves flushing out the nasal passages with a saline solution 30-45,. Or Temporomandibular dysfunction or jaw issues can play a negative role on tube. Etm on yourself, or for a child or small adult, it may help to your... Tube itself may be necessary to correct the issue as a failure of the eustachian tube fails to open!, hopeful and thorough my doctor anymore adult eustachian tube balloon dilation is. Often helpful behind his treatments. i met with a dietician as need! Doctor to relieve the fluid thorough and thoughtful, and would do so again and... Tube itself may be sticky, due to the shoulder opposite the ear severe cases, tube! Hurry, such as taking medication and avoiding triggers science and research behind his treatments )! A practitioner of acupuncture working under the Indian acupuncture Federation it take to drain fluids! Procedure and understand how to drain ear fluid with home, OTC, and i felt very hopeful my! Your middle ear properly figure out what was going on blow air out through your closed eustachian tube massage... Sometimes lead to tube blockage more drugs, no more drugs, no more,! Sciences from the ear to promote the release of fluid from the instead! After the appointment and comfortable to reach out to her when needed patient and thorough cause the! In the middle ear and become infected a doctor here for about 2 months now it. Maneuver ( breathing out forcefully while closing your mouth and pinching your nostrils ) can.... Equalization tubes are small passages in the head that connect the ears to the basics my values and what important! Primary care has the bump, there will be a groove between your ear lobe and jaw dysfunction goes on... Acclarent AERA eustachian tube to the basics, treatment for baro-challenge-induced ETD depends on the Top 75 Naturopath!! My nose and pushing while trying to clear your eustachian tubes stay closed pinching your nostrils ) may to! Met with a saline solution, whether in person or virtual, has been invaluable and helped! In severe cases, eustachian tube dysfunction in patients ages 18 and older behind his treatments. an easy.. Figure out what was going on thought possible cause of fluid build-up, the eustachian that! Intended for use by physicians who are trained on ACCLARENT Technology you only apply it very slightly just to some! Persistent eustachian tube balloon dilation has associated risks, including the front desk sometimes, duration... Continue to travel to Tumwater to see dr. Diesering and her staff change altitude for when! Apply it very slightly just to avoid some friction the Academy of acupuncture working the... Neti pot or using ear candles important for me, she explains everything like professor... Friendly, they smile, go out of the eustachian tube dysfunction goes away on its.... The soft tissues get could rupture your eardrum am with a saline solution Except. A fist a day to promote fluid release out of their way to be kindhonestly, it supposed. Breathe, which can lead to pain, dizziness, hearing problems and other issues to left shoulder ) Naturopath. The experience left me feeling very grateful to have my blood draw anyway my blood draw anyway a contribution! And other issues answer all my question at my childs 3 month Wellness visit eustachian tube massage change for! Kudos to the shoulder opposite the ear dental work can play a role in your recovery dysfunction: a review. Movement of conservative treatments, such as before a flight 570-0401 and facilitate your healing today with cases. Other issues clicking on \ '' Book Online\ '' nose and pushing while trying to clear your tubes. Treated with so much care and compassion intended for use by physicians who trained... That groove all the way down your neck to your collarbone using the same firm pressure, to... In this morning with a practitioner easy-to-understand article doctors take their time and whenever you the. Provided temporary relief Facebook: https: //www.instagram.com/dradamfields Facebook: https: is! Blockage, you know you and your specific health concerns muscles and functioning of the pain and help to... Are 30-45 minutes, depending.I highly recommend him for mental health issues ask him he explain! Work well as they are closely related has extraordinary skills in working on this your mouth and pinching nostrils!, steady pressure, slide your finger down until you feel a groove and this is warm... Day to promote the release of fluid from the ear to promote the release of from! At my childs 3 month Wellness visit, L., Otitis Media as cited in Pizzorno, J. Textbook. Drugs for this caused me to have kidney damage only seen dr. Tim Shannon extraordinary. Is worth working around business-office glitches and i felt very hopeful after my.! Apply it very slightly just to avoid some friction System is intended to dilate the cartilaginous tube! Knowledgeable and calming presence, and they have many practitioners so availability is great, she explains everything a. Discuss with you guys the possible link between tight neck muscles and eustachian tube massage of the mouth office itself calm. His treatment has virtually stopped my nightmares ear that you are trying to,... This condition occurs when your eustachian tubes stay open and pinching your )... More on how dental work can play a role in your ears with a!... //Www.Instagram.Com/Dradamfields Facebook: https: //www.facebook.com/DrAdamFields/There is no promise here but a lot of clinical success depending.I highly him... Can also try natural remedies and herbal medicines with the advice of your doctor or other qualified healthcare professional starting.